CN101330874B - Method and apparatus for guidance and application of high intensity focused ultrasound for control of bleeding due to severed limbs - Google Patents

Method and apparatus for guidance and application of high intensity focused ultrasound for control of bleeding due to severed limbs Download PDF

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CN101330874B
CN101330874B CN 200680046803 CN200680046803A CN101330874B CN 101330874 B CN101330874 B CN 101330874B CN 200680046803 CN200680046803 CN 200680046803 CN 200680046803 A CN200680046803 A CN 200680046803A CN 101330874 B CN101330874 B CN 101330874B
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transducer
flow
blood
treatment
diagnostic
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CN101330874A (en
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H·劳思
J·弗雷泽
J·彼得鲁齐格
S·阿亚提
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皇家飞利浦电子股份有限公司
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Priority to PCT/IB2006/054669 priority patent/WO2007069154A1/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/06Measuring blood flow
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/132Tourniquets
    • A61B17/1322Tourniquets comprising a flexible encircling member
    • A61B17/1325Tourniquets comprising a flexible encircling member with means for applying local pressure
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/132Tourniquets
    • A61B17/135Tourniquets inflatable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/132Tourniquets
    • A61B17/135Tourniquets inflatable
    • A61B17/1355Automated control means therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/68Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6801Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
    • A61B5/6843Monitoring or controlling sensor contact pressure
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/42Details of probe positioning or probe attachment to the patient
    • A61B8/4209Details of probe positioning or probe attachment to the patient by using holders, e.g. positioning frames
    • A61B8/4227Details of probe positioning or probe attachment to the patient by using holders, e.g. positioning frames characterised by straps, belts, cuffs or braces
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/42Details of probe positioning or probe attachment to the patient
    • A61B8/4272Details of probe positioning or probe attachment to the patient involving the acoustic interface between the transducer and the tissue
    • A61B8/4281Details of probe positioning or probe attachment to the patient involving the acoustic interface between the transducer and the tissue characterised by sound-transmitting media or devices for coupling the transducer to the tissue
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/44Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
    • A61B8/4483Constructional features of the ultrasonic, sonic or infrasonic diagnostic device characterised by features of the ultrasound transducer
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N7/00Ultrasound therapy
    • A61N7/02Localised ultrasound hyperthermia
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N7/00Ultrasound therapy
    • A61N2007/0056Beam shaping elements
    • A61N2007/0065Concave transducers
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N7/00Ultrasound therapy
    • A61N7/02Localised ultrasound hyperthermia
    • A61N2007/027Localised ultrasound hyperthermia with multiple foci created simultaneously

Abstract

An ultrasonic diagnostic and therapy system is described for stopping the bleeding of severely damaged blood vessels or vessels severed in a limb amputation. A cuff (30) is attached to the stump of the severed limb which contains a diagnostic transducer array and a HIFU transducer (42, 44). The diagnostic transducer surveys the tissue of the severed limb, searching for a Doppler flow signal. Whena Doppler flow signal is detected, the range to and coordinates of the sample volume where the flow was detected are determined, as well as the flow velocity. This information is supplied to a HIFU therapy transducer controller, which controls the HIFU transducer to transmit focused ultrasound to the sample volume of the flow locus, the center of the lumen of a blood vessel. The focused ultrasound heats and coagulates blood in the severed vessel to stem the bleeding. Heat dissipation due to the blood flow is reduced by tracking and continuously heating the same bolus of blood as it flows, or by heating a significant length of the blood vessel instead of a fixed spot in the vessel.

Description

用于引导和施加高强度聚焦超声波以控制因截肢而出血的 For guiding and applying high intensity focused ultrasound to control bleeding due to amputation

方法和设备 Method and apparatus

[0001] 本发明涉及医学诊断和治疗超声波系统,具体而言涉及利用高强度聚焦超声波控制截断血管的出血的方法和设备。 [0001] The present invention relates to medical diagnostic and therapeutic ultrasound systems, specifically relates to a method and apparatus utilizing high intensity focused ultrasound hemorrhage control cut the blood vessel.

[0002] 在战争期间涉及近端截肢的战场创伤是常见的。 Battlefield trauma [0002] involving the proximal amputations during the war are common. 还可能在车祸和生产事故中以及由于其他原因导致截肢。 It may also be in a car accident and accidents as well as for other reasons lead to amputation. 在这些情况下丧生的主要原因是分别从臂或腿的主动脉、肱动脉和股动脉迅速失血。 The main reason lost their lives in these cases are, respectively, from the arm or leg of the aorta, the brachial artery and femoral artery rapid blood loss. 在紧急环境下很难处理这些伤口,因为动脉的粗糙切除端不会痉挛闭合,而是缩回到肢体中,使得接近并钳住它们很困难或不可能。 In an emergency setting these wounds difficult to handle, because the rough cut end of the artery spasm is not closed, but is retracted into the body, so that close and clamp them difficult or impossible. 希望有一种由受过最少训练的急救医护技术人员在受伤现场使用的方法和设备。 Hope to have a method and apparatus by trained emergency medical care the least trained technical personnel in the injured site.

[0003] 已经表明,应用低MHz频率范围内的高强度聚焦超声波(HIFU)通过加热动脉壁和血液自身的效应减小并消除了穿孔和割开动脉的出血,即使在比上述较大动脉血管更小的动脉中和更低的流速下也是如此。 [0003] It has been shown, the application of high-strength low-frequency range MHz focused ultrasound (HIFU) is reduced and the elimination of the perforations and cut the arterial bleeding by heating the artery walls and the blood itself effect, even in the large arteries more than the the same is true of the small arteries in the lower and lower flow rates. 因此,希望具有能够用于在紧急情况下迅速有效地处理来自任何外围血管的出血的设备和方法。 Accordingly, it is desirable to have an apparatus and method capable of quickly and effectively treated bleeding from any peripheral vessel in case of emergency.

[0004] 根据本发明的原理,描述了治疗设备,其使用施加到受影响肢体的残端的完整或部分袖带,该袖带包括感测流动的换能器和高强度超声波换能器。 [0004] In accordance with the principles of the present invention, the treatment device is described, which is applied to the use of a complete or partial cuff affected limb stump, the cuff comprising a flow sensing transducer and a high intensity ultrasound transducer. 两种换能器处于已知的相互关系,从而能够使用由感测流动的换能器定位或跟踪的血液流动数据来引导将高强度超声波应用到血液流动。 Two kinds of transducers in a known relationship, it is possible to use the blood flow data sensed by the flow transducer to locate or track guided high-intensity ultrasound is applied to the blood flow. 用于换能器以及简单显示机构的支持电子器件可以位于袖带上或附着于袖带的仪器中。 Transducer for simple display means and support electronics may be located on the instrument attached to the cuff or the cuff. 显示器能够使操作者将袖带迅速对准到靠近被检测的流动区域(目标血管)。 The display enables the operator to quickly align to the cuff near the flow region (the target vessel) to be detected. 连接到感测流动的换能器的流动处理器提供对袖带和目标血管之间的距离的自动确定。 Connected to the transducer sensed flow flowing processor provides to automatically determine the distance between the cuff and the target vessel. 高强度超声波换能器可以是环形或线性阵列,并且发射一个或多个沿流动处理器确定的适当深度处的血管聚焦的高强度聚焦超声波(HIFU)斑点或HIFU线束。 High intensity ultrasound transducer may be an annular or linear array, and transmitting one or more high intensity focused vessel at a suitable depth in the flow processor determines focused ultrasound (HIFU) spots, or HIFU harness.

[0005] 在下述实例中,使用多个多普勒和HIFU相位阵列来自动获取高流速血管的位置和功能数据以在系统内部使用,并发射定制的HIFU束,以沿着血管长度的一段加热血管。 [0005] In the following examples, multiple Doppler and HIFU phased array the location and function to automatically obtain a high flow rate data for use in a blood vessel within the system, and transmits custom HIFU beam, along the length of the period of heating the vessel blood vessels. 沿血管长度提供HIFU能量对于成功凝固截断血管中的血液会是很重要的。 Along the length of the vessel to provide HIFU energy to the success of clotting in blood vessels cut will be very important.

[0006] 可以通过阻抗匹配的衬垫或填充流体的外壳来提供袖带换能器到肢体的声耦合。 [0006] The cuff may be provided a transducer coupled to the acoustic impedance of the limb by the pad or fluid-filled housing. 袖带可以与皮肤上耦合凝胶一起使用,以便在所需的扩展区域上迅速实现良好的超声波耦 The cuff can be used with coupling gel on the skin, in order to rapidly achieve a good ultrasound coupling over the extended area required

I=IO I = IO

[0007] 在附图中: [0007] In the drawings:

[0008] 图1以方框图的形式示出根据本发明的原理构造的用于处理截断血管的超声波诊断和治疗系统; [0008] FIG. 1 shows an ultrasonic diagnostic and therapeutic system constructed in accordance with principles of the present invention for treating a blood vessel truncated in block diagram form;

[0009] 图2示出根据本发明的原理构造的换能器袖带的一个实例; [0009] FIG. 2 shows an example of the present invention constructed in accordance with the principles of the transducer cuff;

[0010] 图3示出根据本发明的原理构造的换能器袖带的第二实例; [0010] FIG. 3 shows a second example of the present invention constructed in accordance with the principles of the transducer cuff;

[0011] 图4是根据本发明的原理构造的超声波诊断和治疗设备的信号处理和控制系统的详细方框图; [0011] FIG 4 is a detailed block diagram of the signal processing and control system of an ultrasonic diagnostic and therapeutic apparatus constructed in accordance with the principles of the present invention;

[0012] 图5示出一种使用图2的换能器袖带加热被定位的血管的血液的方法; [0012] FIG. 5 shows a method of using a blood FIG transducer cuff is positioned a heating vessel;

[0013] 图6示出第二种使用图2的换能器袖带加热被定位的血管的血液的方法; [0013] FIG. 6 illustrates a second method of FIG blood transducer 2 is positioned cuff heating vessel;

[0014] 图7示出第一种使用图3的换能器袖带加热被定位的血管的血液的方法;[0015] 图8示出第二种使用图3的换能器袖带加热被定位的血管的血液的方法; [0014] FIG. 7 illustrates a method of heating the blood vessel is positioned using a first transducer of FIG. 3 cuff; [0015] FIG. 8 shows a second transducer 3 to FIG cuff is heated blood vessel positioning method;

[0016] 图9示出第三种使用图3的换能器袖带加热被定位的血管的血液的方法; [0016] FIG 9 illustrates a third method of FIG blood transducer 3 is positioned cuff heating vessel;

[0017] 图10示出根据本发明的原理构造的换能器袖带的第三实例; [0017] FIG 10 shows a third example of the present invention constructed in accordance with the principles of the transducer cuff;

[0018] 图11示出本发明的系统的实例,其具有一排可视指示符,用于在放置换能器袖带使其接近血管的过程中引导用户。 [0018] FIG. 11 illustrates an example of a system according to the present invention, which has a row of visual indicators, in the process for placement of the transducer cuff of a blood vessel guided to approach the user.

[0019] 首先参考图1,以方框图的形式示出了根据本发明的原理构造的用于处理截断血管的超声波诊断和治疗系统。 [0019] Referring first to Figure 1, shown in block diagram form an ultrasonic diagnostic and therapeutic system according to the truncation processing vessel constructed in the principles of the present invention. 在出血血管附近接触被截肢体的换能器袖带10包括诊断换能器12和治疗换能器14。 In the vicinity of the bleeding vessel amputated body contacting transducer cuff 10 includes a diagnostic transducer 12 and a therapy transducer 14. 诊断换能器优选通过血液流动的多普勒检测来定位血管。 Diagnostic transducer is preferably detected by Doppler blood flow to locate a blood vessel. 诊断换能器耦合到系统的诊断部20。 Diagnostic transducer is coupled to the diagnostic section 20 of the system. 诊断换能器受到诊断部的流动收发器22的控制,其激活换能器并从血管接收回波信号。 Diagnostic transducer is controlled by a flow transceiver 22 of the diagnostic unit, which activates a transducer and receiving echo signals from the blood vessel. 将回波信号信息耦合到诊断部的流动处理器M,其确定血管的位置,在下述实例中还确定血液流动速率(速度)。 The echo signal information is coupled to a diagnostic portion of the flow of the processor M, which determines the position of the blood vessel, but also to determine the blood flow rate (velocity) in the following examples. 将该血液流动信息耦合到系统的治疗部130中的治疗处理器132。 The blood flow information is coupled to the treatment portion 130 of the system processor 132 treatment. 治疗处理器132利用该信息通过控制治疗部的治疗发射器134来控制向血液流动提供超声波治疗。 Treatment Treatment by the control processor 132 the transmitter 134 to control the treatment portion of the ultrasonic therapy to the blood flow by using the information. 通过使用诊断换能器提供的位置和流动信息将高强度超声波聚焦到血管的血液上。 A transducer is provided by using the diagnostic location and information flow of the high intensity focused ultrasound to the blood vessel. 持续进行治疗,直到血管中的血液已充分凝结而阻止血液流动为止。 Continued treatment until blood vessels in the blood and prevent clotting so far has been full of blood flow. 所示的显示指示器16位于换能器袖带10上,但也可以位于包含诊断或治疗部的仪器上,其在放置换能器袖带使其接近流动血管的过程中为用户提供目视引导,还可以表示治疗何时进行,何时完成。 Display indicator 16 is shown located on the transducer cuff 10, but may be located on diagnostic or therapeutic instrument comprises a portion, which is placed so close to the transducer cuff of a blood vessel during the flow provide a visual indication to the user the guide can also be expressed when the treatment, is complete. 作为视觉指示器的替代或除此之外,可以由系统产生听觉指令以引导用户。 As an alternative or in addition to a visual indicator, audible instructions may be produced by the system to guide the user.

[0020] 在使用时,将换能器袖带10置于或缠绕于被截肢体的末端周围。 [0020] In use, the transducer cuff 10 is placed or wound around the end of the amputated body. 在使用缠绕型袖带时,使袖带膨胀或勒紧以便处于患者皮肤上和截断血管上方良好的声学和静态位置上。 When using winding type cuff, the cuff is inflated or tightened to the patient's skin and blood vessel above the cutoff good acoustic and static position. 诊断换能器优选通过对换能器下方的最高流动速度进行多普勒感测来定位血管。 By the diagnostic transducer is preferably below the highest flow velocity Doppler transducer senses to locate a blood vessel. 按照血液流动的多普勒速度计算血管的位置。 Calculating the position of the blood vessel in accordance with the Doppler velocity of blood flow. 将该信息提供给治疗处理器,其控制治疗发射器发射高强度超声波,该高强度超声波被聚焦在血管的一定深度和横向位置上。 This information is provided to the treatment processor, which controls the therapy transmitter to transmit high intensity ultrasound, the high intensity focused ultrasound is in a certain depth and lateral position of the blood vessel. 诊断换能器在治疗期间监测血管。 Vascular diagnostic transducer monitoring during treatment. 这种监测可以包括连续跟踪血管的位置以使治疗换能器保持聚焦在血管的适当区域上,以及监测流动,以确定何时发生凝固,何时血液流动停止且何时完成治疗。 Such monitoring may include a continuous track the position of the blood vessel to the therapeutic transducer holder focused on the appropriate area of ​​the vessel, and monitoring the flow to determine when coagulation occurs when blood flow is stopped and when the treatment is completed. 如果需要,也可以显示诊断信息,但这不是必须的。 If desired, you can also display diagnostic information, but this is not necessary. 在下述的一个实例中,在治疗期间通过提供与血管对准的一系列热量来加热一段血管,从而使血液凝固。 In one example described below, during the treatment period blood vessel is heated by providing heat to a series of vessels aligned, so that the blood coagulation. 在另一个实例中,将高强度超声波斑点聚焦在一团血液上并随着血液流动而移动,以在该段血液通过治疗换能器下方的血管移动时连续加热同一段血液。 In another example, the high intensity focused ultrasound spot and moved with the blood flow in the blood of a group, to the segment of blood through the blood vessel below the therapy transducer continuous heating period with the blood moves. 这些技术对于克服由于挟带热量的血液通过并离开截断血管的高流动速率而导致的血管中的热量的连续散失是有用的。 These techniques are useful for overcoming the blood vessel due to the entrainment by the heat and cut away the blood vessel caused by high flow rates in the continuous dissipation of heat. 在动脉的延伸区域之上施加HIFU能量允许将血液加热到足够的温度,以促进凝固,而不会超过所介入组织中的可允许的热剂量。 HIFU energy is applied to allow the blood is heated to a sufficient temperature to promote coagulation in the region extending over the artery, without exceeding the allowable thermal dose in the intervening tissue.

[0021] 以下示出并描述本发明的系统的很多实例。 [0021] shown below and described many examples of systems according to the invention. 在一个实例中,将具有柱形阵列的部分袖带用作HIFU源,从而通过用户在皮肤表面上移动袖带来设置线聚焦超声波束的XY位置。 In one example, the cuff portion having a cylindrical array is used as the HIFU source so the user moves through the sleeve is provided to bring the line focused ultrasound beam position XY on the skin surface. 由简单的用户界面(例如速度计指示器或彩色LED阵列)引导用户,所述界面给出检测到最高流速的皮肤位置的指示。 By a simple user interface (e.g., a speedometer indicator or a color LED array) to guide the user, said interface gives an indication of the detected position of the highest flow rate of the skin. 在HIFU阵列两端和/或旁边的成对诊断检测器阵列使得能够将袖带对准到非常靠近被治疗的血管。 In HIFU arrays at both ends and / or in pairs next diagnostic detector array alignment cuff enables very close to the blood vessel being treated. 基于在多检测器系统上所检测到的最大多普勒信号的范围,通过驱动柱形治疗阵列的发射器电路自动设置HIFU束的聚焦深度。 The maximum range of the Doppler signal based on a multi-detector system detected, the depth of focus HIFU beam is set automatically by the transmitter circuitry driving the cylindrical therapy array. 该实例使用单个大型柱形阵列来提供足够的能量,以沿着血管在延伸区域之上提供凝固效果。 This example uses a single large cylindrical array to provide sufficient energy to provide coagulation effect extends over the region along the vessel. [0022] 在另一个实例中,向肢体施加多相阵列的换能器袖带,从而利用电子束导引检查(interrogate)整个体积。 [0022] In another example, a multiphase transducer array is applied to the cuff body, thereby utilizing the entire volume (interrogate) the electron beam guidance examination. 引导并定位袖带,使得一个或多个治疗HIFU阵列与血管平行。 Guiding and positioning the cuff, such that one or more therapeutic HIFU arrays parallel to the blood vessel. 通过表示截断血管的高流动速率来确定用于凝固的治疗束位置,该高流动速率高于当血液流动速率受到毛细血管床的阻力调节时应当具有的流动速率。 Determining a beam position for treatment represented by coagulation vessel cut high flow rate, the flow rate is high when the blood flow rate is higher than the resistance when subjected to capillary beds should have a flow rate adjustment. 在漏液处附近以及在其周围漏液一直流动的蓄血处(blood pool)中还有多普勒信号的异常。 And leakage around the periphery thereof at the blood pooling has been leakage flow (blood pool) there are abnormal Doppler signal. 在这种情况下,利用多个用于产生治疗功率的换能器来提供足够的功率以进行凝固。 In this case, the treatment for generating a plurality of power transducers provide sufficient power for coagulation.

[0023] 图2是本发明的换能器袖带30的一个实例。 [0023] FIG. 2 is a transducer according to the present invention, one example of the cuff 30. 在此以截面示出的袖带30是一种类似于用于血压测量的套筒的可膨胀囊状套筒。 The cuff 30 is shown in section similar to a sleeve inflatable bladder for blood pressure measurement of the sleeve. 可以将袖带制成不同的尺寸(直径),以用于臂或腿。 The cuff can be made of different sizes (diameters) for arm or leg. 在适于臂用的袖带中,换能器可以完全绕着袖带或仅绕着袖带的弧的一部分延伸, 该弧例如是对着90°到135°弧的换能器的弧。 In a cuff suitable for arm, the transducer may completely around the cuff or cuff arc portion extending around only, for example, against the 90 ° arc to 135 ° arc of the arc of the transducer. 图2所示的实例使用了面向135°的弧的换能器。 Example shown in FIG. 2 was used for an arc of 135 ° transducer. 用于腿的适当的弧大约为9cm乘9cm。 Suitable arc for the leg is approximately 9cm by 9cm. 对于臂,适当的弧大约为6cm乘6cm。 For the arm a suitable arc is approximately 6cm by 6cm. 袖带30具有与患者肢体接触的内表面32和外表面34。 The cuff 30 has an inner surface in contact with a patient's limb 32 and the outer surface 34. 可以用打气泵36使这些表面之间的空间膨胀起来。 Can play pump 36 so that the space between these surfaces inflated. 袖带膨胀实现了三个目的:在袖带内部挤压换能器使其与患者肢体处于良好的声学接触;确保换能器相对于下方的血管处于静止位置;以及在肢体周围提供止血力以帮助阻止血液的流动。 Expansion of the cuff to achieve three purposes: it with extruded transducer limb of a patient in good acoustic contact with the inside of the cuff; ensure that the transducer relative to the vessel below the rest position; and providing hemostasis to a force about the limb help stop the blood flow. 止血带功能还可以减慢血液流动,从而有更多时间来诊断和处理换能器范围内的血液团。 Tourniquet function can also slow down the flow of blood, and more time for diagnosis and treatment of blood groups in the range of the transducer. 还可以用较低剂量的声能来有效处理较低的流动速率。 You can also use a lower dose of acoustic energy to deal effectively with lower flow rates. 将袖带30耦合到治疗和诊断提供系统100,其控制诊断和治疗换能器。 The cuff 30 is coupled to provide therapeutic and diagnostic system 100, which controls the diagnostic and therapy transducers. 换能器附着于袖带的内表面。 A transducer attached to the inner surface of the cuff. 两个柱形曲线阵列治疗HIFU换能器42和44位于内表面上。 Treatment of the two cylindrical curved HIFU transducer arrays 42 and 44 on the inner surface. 在该实例中,在各HIFU换能器的端部和之间留有空隙以放置三个二维相位阵列换能器52、讨和56。 In this example, no gaps transducer HIFU at each end and to place between three two-dimensional phased array transducers 52, 56 and discussion. 安装所有的换能器使其良好地声学耦合到袖带内的患者肢体上。 All transducers mounted so good acoustic coupling to the patient's limb in the cuff. 一种提供声耦合的方式是将换能器置于填充有液体的隔室中。 A method of providing acoustic coupling mode is placed in the transducer compartment is filled with a liquid. 在该实例中,虚线38表示聚氨酯膜,其将换能器包封在膜38和袖带30的内表面32之间的填充有液体的隔室中。 In this example, dashed line 38 represents a polyurethane film, which is encapsulated in the transducer compartment is filled between the inner surface 32 of the cuff 30 and the film 38 in a liquid. 另一种提供声耦合的方式是利用位于换能器发射表面和患者皮肤之间的声耦合衬垫。 Another way to provide acoustic coupling is to use the acoustic coupling between the pad surface and the patient's skin situated emission transducer. 在该实例中,所示的声耦合衬垫46、48、51、53和55位于换能器42、44、52、讨和56的发射表面上。 In this example, the acoustic coupling pad shown 46,48,51,53 and 42,44,52 transducer 55 is positioned, and the emission surface 56 of the discussion. 可以使用分立的衬垫或一个连续的衬垫。 Or you may use a separate liner of a continuous gasket. 该声耦合衬垫可以由固体顺聚丁二烯绝缘材料或凝胶材料制成,例如Kitecko绝缘衬垫。 The acoustic coupling pads may be made of a solid cis-polybutadiene gel material or an insulating material, e.g. Kitecko insulating spacer.

[0024] 二维相位阵列换能器5254和56由切块的压电材料制成。 [0024] made of a two-dimensional phased array transducers 5254 and dicing the piezoelectric material 56. HIFU换能器元件可以由固体压电材料或压电陶瓷与环氧树脂的合成物形成,这能够将弯曲的HIFU阵列弯成所期望的弓形。 HIFU transducer elements may be formed of solid piezoelectric material or a composite of piezoelectric ceramic and epoxy resin, which can be bent into a curved HIFU arrays desired arcuate. 该阵列是二维的,允许对阵列下方的体积进行多普勒检查,使得所述阵列能够系统地搜索肢体内的高流动速率的位置。 The array is two-dimensional, allowing the volume below the array Doppler examination, so that the arrays can systematically search for a high flow rate position of the limb. 沿HIFU换能器42和44的纵向尺度(由箭头L表示)来切割所述HIFU换能器42和44,从而能够在定位血管的皮肤表面下方的选定聚焦深度处聚焦治疗束。 HIFU transducer along a longitudinal dimension 42 and 44 (indicated by arrow L) cutting the HIFU transducer 42 and 44, the depth of focus can be focused at the selected treatment beam positioned beneath the skin surface of the blood vessel. 也可以沿高度方向(进入如E处所示的图平面中)切割HIFU换能器42、 44,从而能够以选定的束角(血管定位在其中)导引和聚焦治疗束,并跟踪血液团通过血管的流动。 It may be in the height direction (as shown at E into the plane of Figure) the cutting HIFU transducer 42, 44, so that the toe angle can be selected (vessel positioned therein) and guide treatment beam focusing, tracking and blood group flows through blood vessels. HIFU换能器优选是背面有类似气孔,以减少背侧的显著加热。 HIFU transducer is preferably similar to the back pores to reduce significant heating of the backside. 导热匹配层和涂有低阻抗中间层的支架可以用于至绝缘衬垫和用于HIFU换能器的机械支撑的良好热传递。 Thermally conductive matching layer and a stent coated with a low impedance intermediate layer may be used to good heat insulation gasket and a HIFU transducer transmitting mechanical support. 优选地,换能器背部附着倒装芯片微束形成器,以控制换能器的操作并通过直接驱动换能器元件来防止驱动电路和换能器元件之间显著的能量损耗。 Preferably, the transducer is attached to the back of a flip-chip microbeamformer to control the operation of the transducer and directly drive the transducer element to prevent significant energy loss between the driving circuitry and the transducer elements. 在美国专利6375617 (Fraser)、 美国专利5997479 (Savord)和美国专利6126602 (Savord)中一般性地描述了适当的微束形成器和微束形成技术。 In U.S. Patent No. 6375617 (Fraser), U.S. Patent No. 5997479 (Savord) and U.S. Patent No. 6126602 (Savord) are generally described appropriate microbeamformer microbeam and forming techniques.

[0025] 治疗换能器42、44例如在2. 5到4MHz的低MHz范围内工作。 [0025] For example the therapy transducer 42, 44 operate in the low range of 2.5 MHz to 4MHz to. 对于非常深的动脉血管,可以优选采用更低的1. 0到1. 5MHz的频率。 For very deep arteries, it can be preferably used lower frequencies of 1.0 to 1. 5MHz. 根据工作深度的期望范围,诊断换能器52、54、56在该范围内或更高的频率上工作,对于较深的腿部深度优选较低的频率,对于较浅的臂部深度优选较高的频率。 The desired range of operating depths, the diagnostic transducer 52, 54 to work on this range or higher frequency, the deeper the depth to the lower leg preferred frequency, for shallower arm depths more preferably high frequency. 通常以全孔径操作诊断换能器,可以以阵列元件组的全孔径或子孔径来操作治疗换能器。 Typically transducers operation diagnosis full aperture, may be full-aperture or sub-aperture array element group is operated therapy transducer. 可以对用于HIFU换能器的驱动脉冲进行脉冲宽度调制,以提高效率。 It can be pulse-width modulating the driving pulses for the HIFU transducer, to improve efficiency.

[0026] 图3以透视图示出本发明的换能器袖带60的第二实例。 [0026] FIG. 3 illustrates a perspective view of a second example of a transducer cuff 60 of the present invention. 在该实例中,除去了袖带的外表面34,以看到袖带的内表面32上的换能器阵列。 In this example, the removal of the outer surface of the cuff 34, in order to see the transducer array on the inner surface of the cuff 32. 排列该实例中的HIFU阵列62和64,使它们的纵轴(如箭头L所示)与袖带的中心轴平行。 HIFU array arrangement 62 and 64 in this example, that their longitudinal axes (as indicated by arrow L) parallel to the central axis of the cuff. 治疗阵列的这种取向将倾向于使它们与延伸到肢体的被截端的血管对齐,尤其是腿和臂的较大的股和肱动脉。 This orientation treatment arrays will tend to be cut so that they extend to the end of the blood vessel and aligned limb, particularly the larger femoral and brachial arteries of the leg and the arm. 2D多普勒阵列71、72、73、74和75位于治疗阵列的端部,治疗阵列之间,或者如图3的实例所示位于这两个位置。 2D Doppler arrays positioned between the end of the treatment portion of the array, the array 71, 72 and 75 therapy, or as in the example of FIG. 3 in these locations. 为了全范围的治疗束聚焦和导弓丨,沿纵向尺度L和高度尺度E(由箭头E表示)这二者切割治疗阵列62和64。 For the treatment beam focusing and guiding bow Shu-wide, along the longitudinal dimension L and a height dimension E (indicated by arrow E) of both arrays 62 and 64, the cutting treatment. 如前所述制造换能器阵列并对其进行声学耦合。 The transducer array manufactured as mentioned above and subjected to the acoustic coupling. 任选地,袖带60可以包括附着于袖带的内表面32上的一个或多个力或压力传感器82、84和86。 Optionally, the cuff 60 may include a cuff attached to the inner surface of one or more force or pressure sensors 32, 82, 84 and 86. 这些传感器可以是压电元件或应变计,其感测袖带的内表面对肢体的力或压力。 The sensor may be a piezoelectric element or a strain gauge, senses the inner surface of the cuff to the limb force or pressure. 当这些传感器产生的信号降到预定极限以下时,它们会产生指示,即该袖带未足够牢固地附着于肢体或变松了,这将会导致换能器阵列和患者之间的声耦合的破坏。 When the signal generated by the sensor falls below a predetermined limit, they produce an indication that the cuff is not sufficiently firmly attached to the body or loosened, which will result in the sound between the transducer array and coupled to a patient damage. 可以通过再次使袖带60 膨胀来解决这种状况。 By the cuff 60 expands again to resolve this situation.

[0027] 图4是根据本发明的原理的另一实例,其中更详细地示出了治疗诊断和输送系统的诊断和治疗部。 [0027] FIG 4 is another example in accordance with the principles of the present invention, which is shown in more detail diagnostic and therapeutic and diagnostic treatment portion of the delivery system. 治疗控制器160控制设备的两个方面。 Two controller 160 controls the treatment device. 治疗控制器160耦合到图像驱动器120,以命令图像驱动器产生用于袖带10的诊断换能器阵列12的驱动信号。 Treatment of the controller 160 is coupled to an image drive 120 to command the video driver generates a drive signal for the diagnostic transducer cuff 10 of the array 12. 这里,术语“图像”并不表示形成了超声波图像,因为在本发明的实施中成像不是必须的。 Here, the term "image" does not mean the formation of an ultrasonic image, because the image is not necessary in the practice of the present invention. 相反,在这里该术语是指由诊断阵列发射的超声波能量处在用于诊断成像的功率范围内而低于治疗用能量范围。 In contrast, where the term refers to ultrasonic energy transmitted by the diagnostic arrays is in the power range used for diagnostic imaging and below the therapeutic energy range. 将驱动信号提供给发射/接收控制器122,其又控制微束形成器124以使诊断阵列12系统地扫描其下方的体积,寻找高强度或速度多普勒回波。 The driving signal is supplied to the transmit / receive controller 122 which in turn controls the micro-beamformer 124 so that the diagnostic system 12 to the array scan volume below it, searching for high intensity or velocity Doppler return. 将发射/接收控制器122 接收到的回波信号耦合到多普勒处理器,该多普勒处理器对来自发射和接收束的回波信号进行多普勒处理,如进行FFT处理那样。 The transmission / reception controller 122 receives the echo signal is coupled to a Doppler processor which Doppler processor echo signal transmission and reception beam from the Doppler processing such as FFT processing. 当截断血管处在诊断阵列之一的范围内时,将从位于血管内肢体中的特定点处的样本体积接收到强或高速多普勒信号。 When the vessel is in the range of one truncated diagnostic array, the received signal strength or a high speed from the Doppler sample volume located at a particular point within a blood vessel in the limb. 可以由多普勒处理器24将该指示作为“检测到的流动”信号传送到治疗控制器160,在这种情况下,治疗控制器将使显示器162上的“流动”LED 164发光。 May be transmitted by the Doppler processor 24 as an indication of the "detected flow" signal to the controller 160 treatment, in this case, the controller will treat "floating" on the display 162 LED 164 light emission. 从多普勒射束方向的角度和返回多普勒信号的范围(深度)可以确定血管中心的x、y、z坐标。 Back range (depth) from the viewpoint of the Doppler signal of the Doppler beam direction and the center of the vessel can be determined x, y, z coordinates. 返回强或高速多普勒信号的相邻样本体积的数量或体积流量的计算结果表示血管的尺寸。 The results returned Doppler signal is strong or high speed adjacent the sample volume or volume flow of the number represent the size of the blood vessel. 将该信息、尺寸、速度(V)和位置(x,y,z) 耦合到治疗规划器150。 This information, size, velocity (V) and position (x, y, z) 150 is coupled to a treatment planning. 其他回波信号可以提供关于血管和阵列之间的组织的其他信息, 例如异物(如弹片或玻璃)的存在,还可以提供关于血管之外易受处理影响的组织(例如骨或神经)的其他信息。 Other echo signals may provide other information about the tissue between the blood vessel and the array such as the presence of foreign matter (such as shrapnel or glass), may also be provided on other than vascular tissue susceptible to treatment effects (such as bone or nerve) Other information. 治疗规划器使用该信息形成用于治疗的控制信号并向治疗控制器160发出信号,表示已经定位了流动源且可以开始治疗。 Therapy planner uses this information to form a control signal for the treatment and therapy controller 160 issues a signal indicating a flow source has been located and treatment can begin.

[0028] 治疗控制器通过使显示器162上的“治疗”LED 164变亮对该信息做出响应。 [0028] By treating the controller "treatment" on the display 162 LED 164 is lit responsive to the information. 治疗控制器命令治疗驱动器142开始工作,并且治疗开始。 Treatment Treatment driver 142 commands the controller to work, and the start of treatment. 治疗驱动器142向治疗束形成器144 提供驱动信号。 Treatment driver 142 supplies a drive signal to the treatment beam 144 is formed. 驱动信号使治疗束由治疗阵列14以治疗规划器150提供的信息确定的功率水平来发射。 Treatment beam 14 so that the drive signal at a power level determined in treatment planning information 150 provided by the array emitted by the treatment. 通常功率水平是血管尺寸(较大的血管需要较多的功率)和流动速率(较高的流动速率需要较多的功率)的函数。 Power level is typically the size of a blood vessel (larger vessels need more power) and the flow rate (higher flow rates requiring more power) function. 治疗规划器150提供血管中心(这里流速最大) 的x、y、ζ位置,治疗驱动器142和治疗束形成器144使用所述位置以沿正确的方向导引治疗束并在血管中心聚焦射束。 Therapy planner 150 provides the blood vessel center (where the maximum flow rate) of the x, y, ζ position, driver 142, and the treatment of the treatment beam 144 is formed using the position in the right direction and guide the treatment beam is a focused beam at the center of the vessel. 时间信号t提供时间变化,该时间变化提供了要在血管中的指示位置处聚焦治疗束的时间的长短。 Providing a time signal t time change, the length of time provides an indication to the position of the focus of the treatment beam in a blood vessel over time.

[0029] 治疗控制器160周期性地中断治疗,以便命令诊断换能器阵列对治疗区域进行重新抽样,以确认血管中心未从其先前确定的位置移开。 [0029] The controller 160 periodically interrupted therapeutic treatment, in order to command the diagnostic transducer array to resample the treatment region, to confirm that the blood vessel is not removed from a previously determined center position. 血液流动的速度和方向表明了在较早时间点发现的血液团在稍后时间点预计要处的位置。 Speed ​​and direction of blood flow in the blood indicate the location of the group found in an earlier time point later point in time is expected to be at. 由诊断换能器扫描预计位置附近的区域并将速度和/或多普勒信号强度最大的最近样本体积标识为在稍后(而非现在)时间点可能会发现此前被加热的血液团的位置。 By the diagnostic transducer scans the area near the expected position and the speed and / or maximum Doppler signal intensity is identified as the nearest sample volume at a later time (rather than the current) time point may find the location of previously heated blood group . 治疗规划器150通过适当调节治疗驱动器142 和束形成器144的控制参数来做出响应。 Treatment planner 150 responds by appropriately adjusting the treatment parameters controlling the drive beam 142 and 144 are formed. 通过这种方式,可以在血液团进入阵列的范围内时开始对其进行加热,并在其流向血管的被截端时对其进行跟踪并继续加热。 May be heated at the start of its group is within a range of blood into the array in this way, and to track the flow of the blood vessel at its truncated end, and heating was continued. 该血液团将处在较高的温度下,于是比通过治疗阵列的固定焦点的血液团更可能促成凝固。 The blood group will be at a higher temperature, more so than in the blood coagulation may contribute to a fixed focus group by treating the array. 通过这种方式,解决了血液流动导致热量散失的问题。 In this way, it solves the problem of blood flow leads to heat loss. 曾研究过该过程涉及的生理现象的其他人指出,加热导致血管收缩,降低流速并使被截端周围的蓄血处凝固形成密封。 Others have studied the physiological phenomena involved in this process indicated that heating causes vasoconstriction, at a reduced flow rate and Xuxue truncated form a seal around the end of solidification.

[0030] 图5示出了通过使用图2的换能器袖带如何可以使该过程发生。 [0030] FIG. 5 shows a transducer by using the cuff 2 how to make the process occurs. 在膨胀的袖带30内部是患者的被截肢体,显示出诸如股骨200的骨位于肢体的中心处。 Inside the cuff 30 is inflated in the patient's amputated body exhibits at the center of the bone such as the femur 200 is located limb. 诸如股动脉202 的血管位于股骨200周围的组织体积中。 Such as the femoral artery 202 is located in the volume of the femur 200 surrounding tissue. 诊断换能器M已经在从换能器阵列M延伸到股动脉的虚线的射束方向上对股动脉202中的血液流动进行了定位。 M transducers have diagnostic blood flow in the femoral artery 202 is positioned in the beam direction from the transducer array into the femoral artery M dashed line. 使用该射束的范围(深度)和方向信息引导治疗阵列42的孔径或子孔径,以将高强度超声波能量聚焦在由从治疗阵列42延伸到股动脉202的实线表示的股动脉处。 Use of the beam range (depth) and directional information to guide the treatment of sub-array aperture or aperture 42 to the high intensity focused ultrasound energy at the treatment in the femoral artery to the femoral artery array 42 extending from the solid line indicated by 202. 由于治疗能量源自皮肤表面处的阵列的延伸长度,因此能量密度不足以导致治疗阵列42和股动脉202之间组织的损伤。 Since the therapeutic energy derived from the extended length of the array at the skin surface, the energy density is insufficient to cause damage to tissue between the therapy array 42, and 202 the femoral artery. 只有当该能量进入到血管内的焦点中时,能量密度才变得高到足以导致截断血管202中的血液的加热和所期望的凝固。 Only when the energy into the blood vessel into the focus of the energy density become high enough to cause only truncation heating vessel 202 and the desired blood coagulation.

[0031] 图6示出了换能器袖带30的换能器阵列如何在血液团通过一段动脉202移动到其被截远端204时跟踪并加热血液团。 The transducer array [0031] FIG. 6 shows a transducer cuff 30 of the section of artery 202 is moved by how the blood group to which the distal end 204 is cut and heated for tracking blood group. 当血液流动进入焦点Fl处的范围内时,开始检测血管202的血液流动。 When the range of the blood flow into focus at Fl, 202 starts to detect blood flow in vessels. 对弯曲2D阵列42的分割能够将治疗束引导到如虚线2、2'表示的焦点Fl处并使其开始在该处聚焦。 Dividing the curved 2D array 42 of the treatment beam can be guided to the focus dotted line 2 'and indicated at Fl where it starts focus. 速度信息表示血液团移动通过血管202的速度,并且在所述血液团移动通过血管时对其进行跟踪和加热。 Speed ​​information indicating speed of the blood vessel 202 by moving groups, and the heating track and moves through the blood vessels of its group. 在稍后的时间,血液团位于焦点F2,如从诊断阵列延伸的虚线5、5'所示,由诊断阵列5254识别该焦点F2。 At a later time, the focal point F2 of the blood group is located, as indicated by the broken line extending array of diagnostic 5,5 ', identified by the diagnostic arrays 5254 to the focal point F2. 使用诊断确定的焦点F2 的范围和位置信息使治疗阵列42在此时聚焦在由虚线4、4'表示的焦点F2处。 Focal point F2 of the range and position information is used to determine the therapeutic diagnostic array 42 at the focal point F2 at this time is focused by a broken line 4, 4 'indicated. 最终同一血液团位于换能器范围、血管的末端,或者这两者的末端,如焦点F3所示。 The final blood groups are located in the same range of the transducer, the blood vessel end, the end or both, as shown in the focus F3. 此时引导治疗束并使其聚焦在虚线6、6'所示的点F3处。 The boot and the treatment beam to be focused at point F3 at the broken line shown 6,6 '. 于是,在同一血液团沿着血管202的长度段行进时,对其进行跟踪和反复或连续的加热。 Thus, when the same blood group travels along the length of the vessel segment 202, to track and repeatedly or continuously heated. 在该实例中看出,使诊断阵列彼此相对取向,使得它们的射束在血管202的区域中相交。 Seen in this example, the relative orientation of the array to one another to make the diagnosis, so that their beams intersect in the area of ​​the vessel 202. 在这种取向下,可以在脉冲回波模式或专用收发模式下操作诊断阵列52、54,在所述脉冲回波模式中,每个阵列发射并随后从其自己的发射接收回波,在专用收发模式中,由诊断阵列之一发射超声波并由另一个用于多普勒处理的诊断阵列接收所得的回波。 In this orientation, the diagnostic arrays 52,54 may be operated in a pulse echo mode or special mode transceiver, the pulse-echo mode, each array transmit and then receives echoes from its own transmission, dedicated a transceiver mode, by one of the other diagnostic array for emitting ultrasonic echoes received by the resulting array of Doppler diagnostic process. 因此在这种构造中可以使用连续波技术。 Therefore, in this configuration may be used continuous wave technology.

[0032] 图7示出了使用根据本发明的原理的图3的袖带60的一种技术。 [0032] FIG. 7 illustrates a technique using a cuff 60 in accordance with the principles of the present invention. FIG. 3. 在所示的取向下,调节袖带的位置,直到“流动”指示器指示血管位于诊断阵列71、72下方为止。 In the orientation shown, adjust the position of the cuff until the "flow" indicator indicates a vessel 71 positioned below the array until the diagnosis. 然后将治疗阵列62与如中心线C所示的血管的轴对准。 Then treating array 62 and the shaft center line C as shown aligned with the blood vessel. 当治疗阵列62是在高度尺度E上分割的二维阵列时,可以沿着治疗阵列62从治疗阵列62到血管202的中心C聚焦射束。 When treating array 62 is divided two-dimensional array in the height dimension E, array 62 may be provided along the treatment from the treatment vessel 62 to the center of the array of focused beam C 202. 可以通过使用治疗阵列一侧或两侧上的诊断阵列(未示出),或者通过向着治疗阵列下方的区域倾斜诊断阵列71、72来确定血管沿着治疗阵列62下方的长度的精确中心。 By treatment with an array side or on both sides of diagnostic array (not shown), or 71 and 72 to determine the exact center of the blood vessel along the length beneath the therapy array 62 by an array toward the region below the therapeutic diagnosis inclined array. 例如,每个诊断阵列71、72可以从其治疗阵列的末端到阵列中心进行扫描。 For example, each diagnostic array 71, 72 to the center of the array can be scanned from the end of the therapy array. 可以通过这种方式找到治疗阵列62下方的血管202的中心C并沿着阵列下方的血管的整个长度对其进行加热。 C can be found in the center of the blood vessel 202 beneath the therapy array 62 in this manner and subjected to heating along the entire length of the vessel below the array. 这是第二种解决因为血液流过截断血管202而导致热量散失的问题的方法。 This is the second solution because the blood flow through the blood vessels cut 202 which led to problems of heat loss.

[0033] 图8类似于图7,除了在该实例中,治疗换能器62的元件子组被聚焦在方位角(纵向)方向,而不是如图7那样被聚焦在在高度方向上。 [0033] FIG. 8 is similar to FIG. 7, except that in this example, the therapy transducer element subset 62 is focused in the azimuthal (longitudinal) direction, as shown in FIG. 7 is not focused in the height direction. 在血管202的中心线C处聚焦沿着阵列的治疗换能器元件的不同连续子组,从将射束聚焦在虚线4-4'之间的阵列一端处的子组到将射束聚焦在虚线2-2'之间的阵列另一端处的子组。 Focused on the center line C of the vessel 202 along successive treatment of different sub-set of transducer elements of the array, from the group focuses the beam at one end of the sub-array between the dashed lines 4-4 'to focus the beam sub-array group at the other end between the dashed lines 2-2 '.

[0034] 图9示出了使用图3的换能器袖带而在血液团流向截断血管202的远端204时跟踪和反复加热所述血液团的情况。 [0034] FIG. 9 shows a transducer cuff FIG. 3 and the truncation of the distal end 202 of the vessel 204 and tracking repeated heating of the blood group of the blood flow in the group. 当诊断阵列72在治疗阵列62的近端定位出血液团时开始对其进行加热。 When the diagnostic array 72 at the proximal end of the therapy array 62 is positioned a blood group starts heating it. 在血液团流向截断血管202的远端时,治疗元件的被激活子组63以流动血液的速度沿阵列62在跟踪方向T上移动,由此在同一血液团穿过治疗阵列62下方的血管段时对其进行反复加热。 Truncation distal vessel 202 in the flow of blood groups, the treatment element is activated subgroup 63 moves at a speed of blood flow in the tracking direction T in the array 62, thereby passing through the vessel segment beneath the therapy array 62 at the same blood group when subjected to repeated heating. 通过位于治疗阵列62纵向末端处的诊断阵列71、72和/或通过位于治疗阵列62—侧或两侧上的诊断阵列(未示出)穿过血管的长度跟踪血管中的血液流动。 71, 72 at the ends of an array of diagnostic and / or therapeutic located by the diagnostic array 62- array side or on both sides (not shown) through the length of the vessel tracking blood flow through a vessel array 62 located at the longitudinal treatment.

[0035] 图10示出了根据本发明的原理构造的局部袖带300。 [0035] FIG. 10 illustrates a partial cuff 300 constructed according to the principles of the invention. 图10中以截面示出的局部袖带300具有内表面304和外表面302,换能器阵列42-56连接到所述内表面304,所述外表面302完成了换能器阵列的包封。 FIG 10 shows a partial cross-section of the cuff 300 has an inner surface 304 and outer surface 302, transducer arrays 42-56 are connected to the inner surface 304, outer surface 302 of the complete encapsulation of the transducer array . 为了换能器的声耦合,所述表面之间的空间可以用流体填充,和/或可以如前所述在内表面304处提供声耦合衬垫。 To transducer acoustically coupled, a space between the surface may be filled with fluid, providing acoustic coupling pad and / or can be at the inner surface 304 as previously described. 通过从局部袖带的每一末端处的内表面304延伸的带306、308将局部阵列附着于患者肢体。 By a belt 304 extending from an inner surface of each end of the partial cuff 306 is attached to the patient's limb of local array. 所述带可以与带扣或夹子或其他固定装置固定在一起。 The belt may be secured together with a buckle or clip or other fastening means. 在图9的实例中,带306、308包括互补的Velcro®表面310 和312,从而能够绕着患者肢体迅速而牢固地将带固定紧,然后能够将其迅速打开和去除。 In the example of FIG. 9, 306, 308 comprises a belt 310 and a complementary Velcro® surface 312, around the patient's limb can be quickly and securely fixed to the belt tightening, which can then be quickly opened and removed.

[0036] 图11示出了本发明的诊断和治疗提供系统的实例,其具有显示器,以帮助引导用户成功地对换能器袖带进行定位。 [0036] FIG. 11 shows an example of diagnosis and treatment system according to the present invention, having a display to help guide the user successfully positioning a transducer cuff. 在该实例中,如结合图1所讨论的那样,袖带10包括至少一个诊断阵列和至少一个治疗阵列14。 In this example, as discussed in conjunction with FIG. 1, the cuff 10 includes at least one diagnostic array and at least one therapy array 14. 在该实例中,旨在将袖带固定成使得治疗阵列14 与受伤肢体的血管平行并位于其正上方。 In this example, the cuff is intended that the fixed array 14 and the treatment of the injured limb and parallel to the vessel located directly above. 利用治疗阵列14与换能器袖带的轴平行的取向容易实现平行取向。 Treatment with array 14 parallel to the axis of orientation of the transducer cuff easy to implement parallel orientation. 通过一行指示器16 (在该实例中为一排LED)使得治疗阵列在血管正上方的对准成为可能。 By line indicator 16 (in this example a row of LED) array such that the treatment vessel is aligned directly above becomes possible. 在最初将袖带设置成与肢体声学接触之后,诊断换能器12系统地扫描袖带内的体积,搜索强和/或高速多普勒信号。 After the cuff is initially placed in contact with the acoustic limb, the diagnostic transducer 12 systematically scan the volume in the cuff, searching intensity and / or high-speed Doppler signal. 在定位到这种血液流动时,多普勒射束与血液流动的侧向角表示必须沿其移动袖带以将治疗阵列14置于血管正上方的方向。 When such a target blood flow, the lateral beam Doppler blood flow angle indicates the therapeutic array 14 must be positioned directly above the vessel along the direction of movement thereof cuff. 例如, 如果血管位于对准的诊断和治疗换能器的左边,在将多普勒射束对准血管中的样本体积时该多普勒射束将向左转变角度。 For example, if a blood vessel is located in the diagnosis and therapy transducer aligned to the left, when the beam is Doppler sample volume vessel alignment of the angle of the Doppler beam will shift to the left. 然后用简单的几何学计算必须移动袖带以将阵列置于血管正上方的距离,此时,在将多普勒射束对准样本体积时所述多普勒射束将正交于换能器的发射表面延伸。 Then simple geometry to calculate the cuff must be moved to bring the array positive distance above the vessel, this time, when the Doppler sample volume of the beam is aligned perpendicular to the beam of the Doppler transducer an emitting surface extends. 在这种情况下不需要精确的距离,只需要必须将袖带向左移动的信息,即射束倾斜的左/右方向。 In this case no precise distance, only the information of the cuff must be moved to the left, i.e. the beam left / right oblique direction. 在图11的实例中,LED行16沿横向向治疗阵列14的左右延伸。 In the example of FIG. 11, LED row 16 extends transversely around the array 14 of treatment. 如果左侧血管的横向距离大于从LED行的中心(由颜色加深的LED表示)到最左侧LED 18的横向距离,则使LED 18变亮。 If the vessel is greater than the lateral distance from the left side of the center of the LED row (represented by the darkened LED) to the leftmost LED 18 is the lateral distance, so that the LED 18 is lit. 用户现在知道必须向左移动袖带。 Users are now aware of the need to move to the left cuff. 随着袖带的移动且多普勒射束角度接近与诊断阵列正交,治疗阵列的中心将接近血管的位置,且随着其越来越靠近, 使越来越向内的LED变亮。 With the movement of the cuff and the Doppler beam angle close to perpendicular to the diagnostic array, the center position of the therapy array will approach the blood vessel and as it gets closer, more inward so that the LED lights. 最后当血管位于治疗阵列下方中心时,使中心LED变亮。 Finally, when the treatment vessel positioned beneath the center of the array, the central LED lights. 变亮的LED的改变就这样迅速引导用户正确地将阵列定位在血管上方,以进行最有效且高效的加热和凝固。 Brightening the LED changes so quickly guide the user correctly positioned over the array of vessels, for the most effective and efficient heating and coagulation.

[0037] 应该理解的是,可以用来自系统的听觉提示来增强或甚至替代LED显示器16,所述听觉提示指示用户“向右移动袖带”或“向左移动袖带”并在将袖带正确定位在血管上方时“停止”。 [0037] It should be understood that the auditory cues from the system can be used to enhance or even replace the LED display 16, the audible prompts the user indicates "move the cuff to the right" or "move to the left cuff" and the cuff when properly positioned over the vessel "stop."

[0038] 上述系统和技术的变化处于本发明的范围之内。 [0038] variations of the above systems and techniques are within the scope of the invention. 例如,如美国专利5984881 (Ishibashi等人)所述,可以通过利用诊断换能器接收从被加热的血液团发射的强谐波,来跟踪被加热的血液团。 For example, as described in US Patent No. 5984881 (Ishibashi et al.), May receive a strong harmonic emitted from the blood groups are heated by using the diagnostic transducer, to track blood groups are heated. 可以通过以接收模式操作治疗换能器来进行血液流动跟踪。 Blood flow can be tracked by receiving the therapy transducer mode. 本领域的技术人员将容易想到其他变化。 Those skilled in the art will readily envision other changes.

Claims (19)

1. 一种超声波诊断和治疗系统,用于通过超声波加热降低外周血管的血液流动,该系统包括:被配置为附着到肢体的换能器袖带,其包括至少一个诊断换能器和至少一个治疗换能器;耦合到所述诊断换能器的流动收发器,其用于控制所述诊断换能器的超声波发射并响应于所发射的超声波接收来自血液流动的回波信号;耦合到所述流动收发器并响应于所述回波信号的流动处理器,其用于识别血液流动的位置;治疗处理器,其响应于对血液流动位置的识别以产生用于所识别位置的治疗控制信号;以及耦合到所述治疗换能器的治疗发射器,其用于使所述治疗换能器向所识别的血液流动位置提供高强度聚焦超声波,其中,所述聚焦超声波在一团血液通过所述血管移动时连续加热这一团血液。 An ultrasonic diagnosis and treatment system for reducing the peripheral blood flow by ultrasonic heating, the system comprising: a is configured to be attached to the transducer cuff limb, comprising at least one diagnostic transducer and at least one therapy transducer; coupled to the diagnostic flow transducer transceiver for controlling the diagnostic ultrasound transducer transmits and receives in response to echo signals from the blood flow in the ultrasonic wave transmitted; coupled to the flow and said transceiver in response to the flow of the echo signal processor, for identifying the position of blood flow; treatment processor, in response to identifying the location of the blood flow signal to generate a control treatment for the identified location ; and a transmitter coupled to the therapeutic treatment of the transducer, for causing the therapy transducer to provide high intensity focused ultrasound to the identified location of blood flow, wherein the focused ultrasound in the blood through a mass of this continuous heating said group of blood vessels during movement.
2.根据权利要求1所述的超声波诊断和治疗系统,其中所述流动处理器包括多普勒处理器,其响应于对多普勒回波信号的接收以识别血液运动的位置。 The ultrasonic diagnostic and therapy system of claim 1, wherein the flow processor comprises a Doppler processor responsive to the reception of Doppler echo signals to identify the position of the blood movement claims.
3.根据权利要求2所述的超声波诊断和治疗系统,其中所述多普勒处理器产生对流速的估算。 The ultrasonic diagnosis and treatment system according to claim 2, wherein said processor generates an estimate of the Doppler velocity.
4.根据权利要求1所述的超声波诊断和治疗系统,其中所述流动收发器控制所述诊断换能器的超声波发射使其处于诊断成像功率极限内。 The ultrasonic diagnostic and therapy system of claim 1, wherein said flow control transceiver the diagnostic ultrasound transducer transmit diagnostic imaging it is in the power limit.
5.根据权利要求4所述的超声波诊断和治疗系统,其中所述治疗发射器用于以在所识别的血液流动位置处产生热量的强度水平提供高强度聚焦超声波。 The ultrasonic diagnosis and treatment system according to claim 4, wherein said therapeutic intensity level transmitter used to generate heat at the identified location of blood flow with high intensity focused ultrasound.
6.根据权利要求1所述的超声波诊断和治疗系统,其中所述流动处理器用于在三维空间中识别血液流动位置。 The ultrasonic diagnostic and therapy system of claim 1, wherein the processor is configured to identify the flow of blood flow position in three dimensional space.
7.根据权利要求5所述的超声波诊断和治疗系统,其中所述治疗处理器包括治疗控制器,所述治疗控制器用于使所述治疗换能器在血管中产生热量,直到由所述流动处理器确定的所述血管中的血液流速降低到可接受的水平为止。 The ultrasonic diagnostic and therapy system of claim 5, wherein said therapeutic treatment comprises a controller processor, the controller for the therapeutic treatment transducer generates heat in the vessel, the flow until the the processor determines blood flow in vessels is reduced until an acceptable level.
8.根据权利要求7所述的超声波诊断和治疗系统,其中所述治疗控制器用于在所述诊断换能器采集流动回波信息时暂停由所述治疗换能器提供高强度聚焦超声波。 8. The ultrasonic diagnostic and therapy system of claim 7, wherein the treatment controller is configured to be suspended from the therapy transducer to provide high intensity focused ultrasound diagnosis when the flow transducer collect echo information.
9.根据权利要求1所述的超声波诊断和治疗系统,其中所述治疗处理器响应于来自所述流动处理器的信号,所述信号表示血管尺寸、所述血管中的血液流速和所述血管中的血液流动位置。 9. The ultrasonic diagnostic and therapy system of claim 1, wherein the treatment processor is responsive to signals from the flow processor, the signal representing blood vessel size, blood flow and the blood vessel of the blood vessel the blood flow position.
10.根据权利要求1所述的超声波诊断和治疗系统,其中所述治疗处理器产生控制信号,所述控制信号控制由所述治疗换能器提供的功率、所述治疗换能器的启动时间以及所提供的高强度聚焦超声波的焦点。 Start time 10. The ultrasonic diagnostic and therapy system of claim 1, wherein the treatment processor generates a control signal, said control signal by the treatment provided by a power transducer, the therapy transducer and a focus provided by a high intensity focused ultrasound.
11.根据权利要求1所述的超声波诊断和治疗系统,其中所述换能器袖带表现出可控制的压力,其用于控制所述诊断换能器及所述治疗换能器与所述肢体的接触。 11. The ultrasonic diagnostic and therapy system of claim 1, wherein the transducer cuff exhibits a controllable pressure, for controlling the diagnostic transducer and the transducer and the treatment the contact limb.
12.根据权利要求11所述的超声波诊断和治疗系统,其中所述换能器袖带表现出可控制的高压力,其用于限制血液流过所述肢体的血管。 The ultrasonic diagnosis and treatment system according to claim 11, wherein the transducer cuff exhibits a controllable high pressure, for restricting blood flow through the limb blood vessels.
13.根据权利要求11所述的超声波诊断和治疗系统,其中所述换能器袖带表现出可控制的高压力,其用于增加所述诊断换能器及所述治疗换能器与所述肢体之间的声耦合。 13. The ultrasonic diagnostic and therapeutic system according to claim 11, wherein the transducer cuff exhibits a controllable high pressure, for increasing the diagnostic transducer and the therapy transducer and the said acoustic coupling between the limbs.
14.根据权利要求11所述的超声波诊断和治疗系统,其中所述换能器袖带表现出可控制的高压力,其用于稳定所述诊断换能器及所述治疗换能器相对于所述肢体中的血管的位置。 14. The ultrasonic diagnostic and therapy system of claim 11, wherein the transducer cuff exhibits a controllable high pressure which is used to stabilize the diagnostic transducer and the transducer relative to the treatment the position of the limb blood vessel.
15.根据权利要求1所述的超声波诊断和治疗系统,还包括显示器,其响应于被启动的所述流动处理器以指示已经识别出血液流动的位置。 15. The ultrasonic diagnostic and therapy system of claim 1, further comprising a display, which is activated in response to the flow of the processor has been identified to indicate the position of blood flow.
16.根据权利要求15所述的超声波诊断和治疗系统,其中所述显示器包括一个或多个发光器件。 16. The ultrasonic diagnostic and therapy system of claim 15, wherein said display includes one or more light emitting devices.
17.根据权利要求16所述的超声波诊断和治疗系统,其中所述显示器包括二维或三维图像显示器。 17. The ultrasonic diagnostic and therapy system of claim 16, wherein said display comprises a two dimensional or three dimensional image display.
18.根据权利要求1所述的超声波诊断和治疗系统,还包括音频发射器,其响应于被启动的所述流动处理器以指示已经识别出血液流动的位置。 18. The ultrasonic diagnostic and therapy system of claim 1, further comprising an audio transmitter, in response to the flow is activated the processor has been identified to indicate the position of blood flow.
19.根据权利要求18所述的超声波诊断和治疗系统,其中所述音频发射器进一步响应于所述流动处理器以弓I导所述换能器袖带的放置。 19. The ultrasonic diagnostic and therapy system of claim 18, wherein said audio transmitter is further responsive to the flow processor to guide the placement bow I transducer cuff transducer.
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